Increase in opioid use is not prescription for abuse

Conventional wisdom that drugs used for relief of severe pain — such as morphine — are widely abused was challenged by a recent study published in the Journal of the American Medical Association.

The study looked at the use of opioids in the early 1990s and their rate of abuse. It also compared the rate of abuse of opioids to the abuse of illicit drugs. The study, published in the April 5 issue, was done by the Pain & Policy Studies Group (PPSG) of the University of Wisconsin Comprehensive Cancer Center. Researchers examined data from two government-sponsored sources: the Drug Enforcement Agency’s medical use data from the Automation of Reports and Consolidated Orders System, which collects information on the national distribution of selected drugs to pharmacies and hospitals, and abuse data from the Drug Abuse Warning Network, which collects data about drug overdoses from a nationally representative sample of general hospital emergency departments.

The study found that from 1990 to 1996, U.S. physicians prescribed significantly more opioids. "Although there are many ways to treat pain, the increased medical use of opioids is a strong indicator that we are making progress to improve pain management," said David E. Joranson, lead author and PPSG director.

The study also found that abuse of opioids was low and stable, accounting for a small part (less than 5%) of the national drug abuse problem, as measured by drug overdoses. From 1990 to 1996, abuse of opioids increased 6.6%, in contrast with the abuse of the category "illicit drugs," including cocaine and heroin, which increased by 109%.

"These results indicate that the United States could be a model for how to achieve a balanced controlled substances policy; that is, one which can improve the availability of opioids for medical purposes while limiting abuse," said co-author Karen Ryan, chief policy analyst for the PPSG.

Joranson added that the danger for abuse should not be taken lightly. "We must continue to exercise caution with opioids, since there is an illicit demand for these drugs. Health care professionals and patients should continue to exercise appropriate care to avoid diversion and abuse of pain medications."